# Neural pathways underlying the production of pitch and rhythm in aphasia

## TL;DR

This study explores how singing is affected in people with poststroke aphasia and identifies the brain networks involved in singing accuracy.

## Contribution

The study reveals that singing accuracy in aphasia is linked to both left and right hemisphere neural pathways, offering new insights for music-based rehabilitation.

## Key findings

- PSA patients showed poorer singing accuracy in pitch, melodic contour, and rhythm compared to healthy controls.
- Singing accuracy is associated with the left-lateralized dual stream network and additional pathways in the right hemisphere.
- The findings suggest potential for using music's structure in language recovery and rehabilitation.

## Abstract

Singing is a universal human attribute. Previous studies suggest that the ability to produce words through singing can be preserved in poststroke aphasia (PSA) and that this is mainly subserved by the spared parts of the left‐lateralized language network. However, it remains unclear to what extent the production of rhythmic–melodic acoustic patterns in singing remains preserved in aphasia and which neural networks and hemisphere(s) are involved in this. In this cross‐sectional study, we set out to investigate the structural neural networks underpinning singing production abilities by combining a whole‐brain white matter correlational tractography approach together with a comprehensive appraisal of pitch, melodic contour, and rhythm production accuracy during both spontaneous and cued singing in a sample of 45 patients with PSA. Our results indicate that PSA patients have poorer singing accuracy (pitch, melodic contour, and rhythm) than matched healthy controls (N = 33). The network associated with singing accuracy in aphasia was identified in the left hemisphere–dominant dual stream network involved in auditory‐motor integration of speech, but also extends to multiple other associative and projection pathways, also in the right hemisphere. The results provide insight into alternative communication methods and therapeutic approaches, leveraging music's inherent structure to aid in language recovery and rehabilitation.

Singing is a universal trait, and prior studies suggest singing ability may be preserved in poststroke aphasia. This study examined neural networks underpinning singing in patients with aphasia using white matter connectometry and singing accuracy assessments. Results showed patients with aphasia had poorer singing accuracy than controls, linked to the left‐lateralized dual stream network and other pathways, including the right hemisphere, offering insights for language rehabilitation through music.